Individual
TARA COTHRAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA, LPC-S, ADC
Contact information
Practice address
900 BOWMAN ROAD SUITE 103, MT PLEASANT, SC 29464
(864) 593-9544
Mailing address
78 FOLLY ROAD BLVD STE B9, #1034, CHARLESTON, SC 29407-7551
(864) 593-9544
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
8035
SC
103TC1900X
Counseling Psychologist
5611
SC
Other
Enumeration date
11/09/2020
Last updated
12/21/2022
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